In the One Big Beautiful Bill era, capacity is more than a scheduling concern for hospitals and health systems — it’s a financial imperative. During a recent Becker’s Healthcare webinar hosted by LeanTaaS, executives from University Hospitals (Cleveland), Sutter Health (Sacramento, Calif.) and Scripps Health (San Diego) shared how their systems are leveraging predictive analytics, real-time data and cultural accountability to navigate tightening margins and rising demand.
Panelists shared their strategies in leveraging real-time data and visibility to boost operational agility, unlock capacity and ultimately safeguard access to care amid escalating financial headwinds. At University Hospitals, for example, smarter OR utilization efforts have raised productivity from 50% to 85%, translating into significant margin improvement.
Below are five key takeaways from the session.
1. Real-time data is essential to bridging capacity and access.
At Sutter Auburn (Calif.) Faith Hospital, data has become a strategic foundation for managing capacity and demand. “We are approaching [capacity and access] through a lens of data-driven agility,” said CEO Shanthi Margoschis, MSN, DHA, NEA-BC, FACHE. She emphasized the importance of real-time operational insights to anticipate bottlenecks, align staffing and maintain care quality.
The hospital has also prioritized data fluency among leaders. “Behind every story, there’s numbers, and every number needs to lead to a story,” Ms. Margoschis said. A recent initiative trained teams to interpret and act on data with confidence — a shift that has empowered better balancing of clinical and operational goals.
2. Systems are making ‘hidden’ capacity visible and profitable.
University Hospitals is managing complexity by making capacity optimization a core tenet of its clinical transformation strategy. Peter Pronovost, MD, PhD, FCCM
, the system’s chief clinical transformation officer, noted that value-based and fee-for-service models can coexist when capacity is leveraged effectively.
Using LeanTaaS’ playbooks, the system increased OR utilization from 50% to 85% and boosted physician productivity to around 80%. The key was making capacity visible and manageable. Additionally, the team used data to convert inpatient units into higher-margin service lines by shifting four patients per day to ambulatory care settings.
“Access problems, so often, are our own making,” Dr. Pronovost said. “There is capacity — it just isn’t leveraged.”
3. Systemwide coordination enables proactive resource planning.
Scripps Health has centralized operations through a corporate command center and transfer hub. “We’re using predictive analytics at a system level to look six to eight weeks ahead, and sometimes even six months ahead, to determine what our staffing needs are,” Chris Van Gorder, MPA, FACHE, president and CEO of Scripps, said. These forecasts guide decisions on hiring, training and ICU staffing, making the system more responsive and resilient.
The health system has also rolled out standardized models of care across facilities using lean principles. Front-line staff now welcome these efforts as tools for improvement rather than top-down mandates. “People are applauding the fact that it’s finally their turn to have a hand in systemwide change management,” Mr. Van Gorder said.
4. Accountability and culture change drive sustained improvements.
All three health system executives emphasized that data alone isn’t enough; culture and accountability are essential. Dr. Pronovost described a “handshake, not hammer” approach to shared accountability, reinforced by clear expectations and run charts that reflect performance over time. “If you can show me a run chart of a measure that matters, that has a slope other than zero, you have a management system,” he said.
By embedding these principles into daily workflows, systems are making capacity optimization a strategic lever, not a reactive fix.
5. Forward-looking organizations are preparing for financial pressures ahead.
Hospitals face growing financial challenges stemming from site-neutral payments, potential 340B cuts and reimbursement pressures. Leaders warned that organizations slow to adapt may face consolidation or service line closures.
“We message to the front-line staff that we need to get our cost structure down so we’re profitable on Medicare-level payments,” Dr. Pronovost said.
Mr. Van Gorder added: “We have a crisis that’s going to create opportunity for those who view it as an opportunity to become better.”
Building contingency plans and shifting from reactive to predictive operations are now table stakes for resilience. “We have to move from reactive problem-solving to becoming more proactive,” Ms. Margoschis said. “We need to invest in predictive and AI-driven insights — that’s the only way we’ll be able to anticipate demand and optimize resources.”
Through strategic use of technology and disciplined management practices, health systems are converting capacity challenges into opportunities for margin recovery and care continuity. AI-driven solutions such as LeanTaaS’ iQueue suite are helping hospitals meet the moment — not only to survive, but to evolve.
